Chest examinations by X-ray photography commonly require exposure of X-ray film while an infant or child is in an upright position. The chest X-ray examination typically involves anterior-posterior and lateral exposures.
Because the cooperation of babies and small children in these X-ray procedures is often lacking, it is usually necessary that an adult manually restrain the child while the film is being exposed. Unfortunately, this subjects the adult to the risk of exposure to X-ray radiation. Even with this form of immobilization inadvertent movement can easily take place. If the patient is not motionless during exposure, clouding or double-imaging occurs necessitating retakes of the photograph to achieve a clear image.
Previous restraining devices have been provided for immobilizing young children during X-ray studies. U.S. Pat. Nos. 3,358,141, to Hoffmann et al., 3,526,222, to Dreibelbis, 3,650,523, to Darby, Jr., and, 3,933,154, to Cabansag, have offered immobilizers in the form of planar supports having straps for restraining the patient. The Cabansag patent further includes a flexible backer member allowing the patient to be placed in various orientations for X-ray examination of different parts of the anatomy.
U.S. Pat. No. 4,027,869, issued to this inventor, provides a planar member particularly suited for hip studies requiring the so-called frog-leg position.
These foregoing apparatuses do not include film holders and require that the apparatus, with restrained patient, be moved adjacent a film holding means. Further, such immobilizers require that they be radiotransparent in order to avoid shadows on the photographic images. Additionally, they must have sufficient sturdiness to permit moving the device and patient into proper anatomical positioning for the X-ray photograph.
U.S. Pat. Nos. 3,051,832, to Pigg, and 3,892,399, to Cabansag, disclose restraining apparatuses which include film holding means positioned adjacent the immobilization portions. The Pigg device restrains the child in a body-conforming structure which holds the child upright with arms extending vertically above the head. Straps or bands are not the primary restraining device but rather two opposing body-conforming portions are laterally expansible to accommodate various sized children therebetween. Held in such fashion, the patient may be rotated to the desired anatomical position in front of the X-ray film holder. The child's legs extend unrestrained below a mid-body planar section whereby undesired movement may take place. Also, with the arms held above the head, an uncomfortable position is imposed, which may lead to disquietude in the young patient.
The Cabansag apparatus is a chair-like device which positions the patient in a seated fashion with his back next to a film holder. The device further provides a lateral film holder, which may be pivotable. Like the Pigg structure, the Cabansag restraint may be rotatable. The film holding means is radially dislocatable to permit rotation of the chair-like device. A radio-transparent backer for the chair is needed inasmuch as it is disposed between the patient and film. The Cabansag apparatus offers restraints for the head, torso, legs and ankles. The examinee's arms may be restrained upwardly, above the shoulders, with a pair of arm straps at either side of a head restraining strap.
It is a primary goal of the invention to provide a simplified pediatric retraining device which affords comfortable positioning of the patient with minimal strapping to achieve the proper anatomical posture for anterior-posterior or lateral X-ray examination of the upper torso of the child.
It is an important object of the invention to provide an adjustable restraining apparatus for use with children up to about four years of age which affords adjustment of only a single vertical adjustment means to accommodate young patients in this range of sizes.
It is further an object of the invention to provide adjustable film holding means for X-ray film cassettes which can accommodate different sized film cassettes.
It is also an important goal of the invention to restrain the arms of the patient upwardly and outwardly on wing-like extensions forming arm rest means which attains the correct and preferred anatomical positioning of the chest for X-ray study.
It is an allied object of the invention to restrain the child with a minimum number of straps in a relatively comfortable position to gain patient cooperation and calmness.
It is therefore a concomitant object of the invention to position the patient in a seated position with arms restrained and supported in a relaxing posture at resting surfaces having an upward and outward extension.
It is also an object of the invention to provide a relatively inexpensive device which is portable, easily stored, and requires only minor adjustments for patient and film sizes.
It is an aim of the invention to securely immobilize the patient with a back strap, leg strap and arm straps by which the immature patient may be constrained in a relatively natural position.
It is a concomitant object of the invention to include means for holding grid filter panels which is formed integrally with the film cassette holding means.
The invention may be summarized as having a generally rectangular planar padded seat whereupon the patient sits lengthwise. At one end, the seat has overlying straps for leg restraint. An upright is fixed along a side edge of the seat with a vertically sliding sleeve engaged therearound. A locking knob means serves to vertically adjust the sleeve to desired positions. A cross framework associates with a side framework, and both are vertically movable by adjusting the sliding sleeve. The cross framework extends across the seat generally above the patient's thighs. The side framework extends along the side of the seat laterally of the patient's chest. Each framework includes film holding means having a pair of upper and lower, opposingly faced, horizontal double-channel members. Independent channel adjustment means are cooperative with each pair of double-channel members. The channel adjustment means movably interconnect the double-channel members and provide for relative vertical movement of the opposing double-channel members for the accommodation of different sized X-ray film cassettes.
The cross framework further includes wing-shaped arm rests extending patient-outwardly and upwardly generally from opposite ends of the upper double-channel. The arms and upper back of the patient are restrained by strap and strap holder means associated with the arm rests for securement from wrist-to-wrist with the strap extending around the upper back, or shoulders, of the patient. A strap and strap holder means associate with the lower double-channel for restraint around the lower back of the pediatric patient. The chest is immobilized closely adjacent the cross framework, and the side framework is positioned laterally of the patient.
In the preferred form, the side framework connects to a supporting tubular cross-bar of the cross framework by means of a slide arm movably positioned within the tubular cross-bar. Thereby, the side framework is also laterally movable with respect to the seat and patient, as well as being vertically adjustable by means of the locking knob and sliding sleeve.